Individual
NICOLE STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED, BCBA, LBA-NY
Contact information
Practice address
20 OAKVIEW AVE, MAPLEWOOD, NJ 07040-2214
(973) 809-3543
Mailing address
20 OAKVIEW AVE, MAPLEWOOD, NJ 07040-2214
(973) 809-3543
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000650
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000650
LBA
NY
01
—
1-12-10434
BCBA
—
Enumeration date
05/16/2017
Last updated
05/23/2021
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